Systematic Review of Voluntary Participation in Simulation-Based Laparoscopic Skills Training: Motivators and Barriers for Surgical Trainee Attendance

• Published in: Journal of surgical education 2017-03, Vol.74 (2), p.306-318
• Main Authors: Gostlow, Hannah, MBBS, Marlow, Nicholas, MA, PubHealth, Babidge, Wendy, PhD, B App Sci(Hons), Grad Dip Bus, FAIMM, CPMgr, GAICD, Maddern, Guy, MBBS, PhD, MS, MD, FRACS
• Format: Article
• Language: English
• Subjects: Adult; Attitude of Health Personnel; Clinical Competence; Cohort Studies; Education, Medical, Graduate - methods; Female; Healthy Volunteers; Humans; Internship and Residency - organization & administration; laparoscopy; Laparoscopy - education; Male; Medical knowledge; Motivation; Practice-based learning and improvement; Randomized Controlled Trials as Topic; self-directed learning; Simulation Training; simulation-based education; Surgeons - psychology; Surgeons - statistics & numerical data; Surgery; surgical education; voluntary training
• ISSN: 1931-7204; 1878-7452
• DOI: 10.1016/j.jsurg.2016.10.007

Objective To examine and report on evidence relating to surgical trainees’ voluntary participation in simulation-based laparoscopic skills training. Specifically, the underlying motivators, enablers, and barriers faced by surgical trainees with regard to attending training sessions on a regular basis. Design A systematic search of the literature (PubMed; CINAHL; EMBASE; Cochrane Collaboration) was conducted between May and July 2015. Studies were included on whether they reported on surgical trainee attendance at voluntary, simulation-based laparoscopic skills training sessions, in addition to qualitative data regarding participant’s perceived barriers and motivators influencing their decision to attend such training. Factors affecting a trainee’s motivation were categorized as either intrinsic (internal) or extrinsic (external). Results Two randomised control trials and 7 case series’ met our inclusion criteria. Included studies were small and generally poor quality. Overall, voluntary simulation-based laparoscopic skills training was not well attended. Intrinsic motivators included clearly defined personal performance goals and relevance to clinical practice. Extrinsic motivators included clinical responsibilities and available free time, simulator location close to clinical training, and setting obligatory assessments or mandated training sessions. The effect of each of these factors was variable, and largely dependent on the individual trainee. The greatest reported barrier to attending voluntary training was the lack of available free time. Conclusion Although data quality is limited, it can be seen that providing unrestricted access to simulator equipment is not effective in motivating surgical trainees to voluntarily participate in simulation-based laparoscopic skills training. To successfully encourage participation, consideration needs to be given to the factors influencing motivation to attend training. Further research, including better designed randomised control trials and large-scale surveys, is required to provide more definitive answers to the degree in which various incentives influence trainees’ motivations and actual attendance rates.